Kan Ürünü Kullanımı Analizi: Hangi Hastalarda? Kalp Cerrahisinde Bir Yıllık İntraoperatif Hangi Ameliyatlarda? Ne Kadar?

Key Findings & Data:Objective: To optimize the transfusion strategy and to be able to take measures during the preoperative period, it is necessary to identify the subgroups of patients at high risk of bleeding.

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Conclusion & Impact:Besides increased rates of mortality were

🔬Design:Research Article

📍Scope:2015 Verileri

⚙️Variables:Domain Parameters

Abstract

One Year Intraoperative Blood Transfusion Usage Analysis in Cardiac Surgery: Which Patients? Which Surgeries? How Much? Objective: To optimize the transfusion strategy and to be able to take measures during the preoperative period, it is necessary to identify the subgroups of patients at high risk of bleeding. The purpose of this study, is to investigate the distribution of the frequency of intraoperative blood product use in patients with cardiac surgery based on patient characteristics, and type of surgery and determine the relationship between results and mortality. Material and Methods: In 2015, 1023 patients who had undergone cardiac surgery, were analyzed retrospectively. Information about patient’s age, sex, BMI, disease, preoperative hemoglobin, hematocrit, INR, aPTT, quantities of blood products used, cross-clamping time, duration of CPB and surgery and 30-day mortality were recorded. Patients were divided into 3 groups, according to the number of units of packed red cells (RBC) used as , Group I (never used), Group II (1-2 units), and Group III (≥3 units). Results: Group I consisted of 43.01%, Group II, 43.1%, and Group III 13.8% of all patients, respectively. Age, gender, INR values between Groups I and III were significantly different, and BMI, ASA risk classification, Hb/Htc values and cross/CPB/operation time were found to be statistically significantly different in all three groups (p<0.001). Maximum use of the packed RBC was observed (3.1Ü) during re-operations, while it was used at a minimum amount during surgeries performed for congenital malformations in adults. The 30-day mortality rate was 8.1% for all patients, 30.3% in Group III, 6.3% in Group II and 2.7% in Group I (p<0.001). Discussion and Conclusion: Advanced age,female sex, prolongation of operation/CPB/Cross-clamping, low baseline Hb/Htc values and some types of surgery increased the use of RBC. Besides increased rates of mortality were

Özet

Amaç: Transfüzyon stratejilerini optimize etmek ve preoperatif dönemde önlem alabilmek için yüksek kanama riskindeki hasta alt gruplarının belirlenmesi gerekmektedir. Bu çalışmanın amacı, kalp cerrahisinde intraoperatif kan ürünü kullanım sıklığının hasta özelliklerine ve cerrahi tipine göre dağılımını araştırmak, sonuçların mortaliteyle ilişkisini saptamaktır. Gereç ve Yöntem: 2015 yılında kardiyak operasyon geçirmiş 1023 hasta retrospektif incelendi. Hastalara ait yaş, cinsiyet, BMI, olgu türü, preoperatif Hb, Htc, INR, aPTT değerleri, kan ürünü kullanım miktarları, kros klemp, KPB ve ameliyat süreleri ile 30 günlük mortalite bilgileri kaydedildi. Hastalar Eritrosit süspansiyonu (ES) kullanım sayılarına göre hiç ES kullanılmayan Grup I, 1-2Ü ES kullanılan Grup II, 3 ve üstü ES kullanılanlar Grup III olmak üzere 3 gruba ayrıldı.Bulgular: Tüm hastaların %43.01'i Grup I'de, %43.1'i Grup II'de ve %13.8'i Grup III'de idi. Yaş, cinsiyet, INR değeri Grup I ve III arasında anlamlı farklı, BMI, ASA risk sınıflaması, Hb/Htc değerleri ile kros/KPB/operasyon süreleri her üç grupta da istatistiksel olarak anlamlı farklı tespit edildi (p<0.001). Olgu türüne göre en fazla ES kullanımı (3.13Ü) re-operasyonlar, en az oranda ES kullanımı ise erişkin konjenital cerrahisiydi. Otuz günlük mortalite oranları tüm hastalar için %8.1, Grup III'de %30.3, Grup II'de %6.3 ve Grup I'de %2.7 idi (p<0.001)

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Cite This Article

DEMİR, A., YAĞAR, S., AYGÜN, E., ÜNAL, U., BÖLÜKBAŞI, D., KOÇULU, R., AYKUT, A., SERT, G. S., KEMERCİ, P., BALCI, E. (2016). Kan Ürünü Kullanımı Analizi: Hangi Hastalarda? Kalp Cerrahisinde Bir Yıllık İntraoperatif Hangi Ameliyatlarda? Ne Kadar?. Göğüs Kalp Damar Anestezi ve Yoğun Bakım Derneği Dergisi, Cilt: 22 - Sayı: 2, 62–69. https://ajindex.com/articles/178123

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